People in menopause experiencing upsetting stressful events are more likely to have worsened menopause symptoms--and the level of social support they receive doesn't seem to moderate the impact on symptoms, according to a study published January 27, 2021 in the open-access journal PLOS ONE by Megan Arnot from the University College London, UK, and colleagues.
Menopause for many people comes with difficult physical symptoms, most frequently vasomotor symptoms (VMS). VMS affects about 70 percent of people undergoing menopause and includes symptoms like hot flashes, night sweats, and cold sweats. Though stress has long been known to worsen menopausal symptoms, there has been some evidence that social support eases symptoms; in this study, Arnot and colleagues examine whether social support is an effective buffer against stress's negative effects on VMS.
The authors analyzed nine years of data from the ongoing Study of Women's Health Across the Nation (n = 2718). The women surveyed were based in the US, mostly perimenopausal (60 percent), 47 years old on average, and tended to be in a relationship or married (76 percent). In terms of ethnicity, 49 percent of responders were white, 25 percent black, seven percent Hispanic, and 17 percent Asian-American. Women were receiving high levels of social support on average (M: 4.18; SD: 0.78,), most had experienced a stressful event that was at least somewhat upsetting to them (76.49%), and the respondents had experienced on average 3 (SD: 2.45) stressful events in the past year. (The respondents were able to rate how upsetting they found each stressful event, from not at all upsetting to very upsetting.)
After adjusting for age, marital status, smoking, self-perceived overall health, ethnicity, and menopausal status, the authors found that the degree to which the woman was affected by the stressor was most critical in terms of the effect on VMS: women who reported themselves still upset by a stressful event in the last year tended to have a 21 percent increase in VMS frequency, and women who had been very upset in the past year but described themselves as no longer upset still experienced a seven percent increase in VMS frequency. Women who weren't upset or only somewhat upset by stressful events didn't show a statistically-significant increase in VMS upon reporting. Interestingly, the authors did not find a relationship between increased social support and decreased VMS, or evidence that social support moderated the negative impact of stress on VMS.
The original survey questions may not have been specific enough to adequately capture the impact of social support on menopause symptoms; the authors also point out that talking about menopause could lead to anticipation of negative symptoms and thus potentially worsen the woman's experience. They suggest future research focus on whether social interventions do have a positive effect on menopause symptoms, and also whether certain personality types-in regards to resilience-experience menopause differently.
The authors add: "This study is the first demonstrating that social support doesn't necessarily make the menopausal transition 'easier', which casts doubt over the efficacy of support-based treatments."
Citation: Arnot M, Emmott EH, Mace R (2021) The relationship between social support, stressful events, and menopause symptoms. PLoS ONE 16(1): e0245444. https:/
Funding: MA is funded by the ESRC-BBSRC Soc-B Centre for Doctoral Training (grant no. ES/P000347/1). The funders had no role in study design, data collection and analysis, decision to public, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
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